TY - JOUR
T1 - Management of Refractory Cancer Pain with Intrathecal Drug Delivery and Spinal Cord Stimulation
AU - Bulat, Evgeny
AU - Crowther, Jason E.
AU - Chakravarthy, Vikram
AU - Laufer, Ilya
AU - Barzilai, Ori
AU - Gulati, Amitabh
N1 - Publisher Copyright:
© Evgeny Bulat et al., 2024; Published by Mary Ann Liebert, Inc.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - Background: Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy. Materials and Methods: A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain. Primary outcomes were pain numeric rating scale (NRS) and daily morphine equivalents (MEQs). Results: Seventeen patients were identified. Both ITP and SCS were associated with significant decreases in pain ratings at the 3-month follow-up, but this decrease became nonsignificant subsequently. ITP, but not SCS, was associated with a significant decrease in MEQ. Conclusions: ITP and SCS may both provide efficacy for cancer pain, but the opioid-sparing effects of SCS may be limited. ITP and SCS may potentially be complementary in their ability to provide relief from cancer-related pain.
AB - Background: Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy. Materials and Methods: A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain. Primary outcomes were pain numeric rating scale (NRS) and daily morphine equivalents (MEQs). Results: Seventeen patients were identified. Both ITP and SCS were associated with significant decreases in pain ratings at the 3-month follow-up, but this decrease became nonsignificant subsequently. ITP, but not SCS, was associated with a significant decrease in MEQ. Conclusions: ITP and SCS may both provide efficacy for cancer pain, but the opioid-sparing effects of SCS may be limited. ITP and SCS may potentially be complementary in their ability to provide relief from cancer-related pain.
KW - cancer pain
KW - intrathecal pump
KW - neuromodulation
KW - opioids
KW - spinal cord stimulator
UR - http://www.scopus.com/inward/record.url?scp=85200534573&partnerID=8YFLogxK
U2 - 10.1089/pmr.2023.0089
DO - 10.1089/pmr.2023.0089
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C2 - 39144131
AN - SCOPUS:85200534573
SN - 2689-2820
VL - 5
SP - 301
EP - 305
JO - Palliative Medicine Reports
JF - Palliative Medicine Reports
IS - 1
ER -